CDC: Teens Seeing More E-Cigarette Ads

-80% exposed to a vaping ad in 2016, survey suggests

Teens in the U.S. are seeing more ads promoting electronic cigarette use, with point-of-sale advertising the most common source of exposure, the CDC reports.

The study, published in Morbidity and Mortality Weekly Report, suggests that four out of five middle-school and high-school students, or 20.5 million U.S. teenagers, were exposed to at least one type of e-cigarette advertisement in 2016, compared with 18.3 million 2 years earlier -- a change that represents a 13% increase in exposure to vaping ads in just 2 years.

The researchers, led by Kristy Marynak, MPP, found that seven in 10 teens saw the vaping ads in convenience stores and other retail establishments in 2016, while two in five saw the ads on the internet or television, and one in four saw them in newspapers or magazines.

Action Points

Teens in the U.S. were exposed to more advertisements promoting electronic cigarette (e-cigarette) use in 2016 than in prior years, with point-of-sale advertising the most common source of exposure, according to the CDC.

Be aware that e-cigarettes have become the most commonly used tobacco product among U.S. middle-school and high-school students, and studies suggest that exposure to advertising may reduce young people's perception of harm linked to use of the products.

E-cigarettes have become the most commonly used tobacco product among middle-school and high-school students in the U.S., and studies suggest that exposure to advertising for the products may reduce young people's perception of harm linked to the products' use, the investigators said.

In a separate study, published online in Pediatrics, three out of four surveyed teens who vaped (74.6%) but did not use other tobacco products said they believed e-cigarette use was not harmful.

"Now that I've switched to Blu, I feel better about myself," she says. "And I feel free to have one almost anywhere -- when I'm driving, at home watching TV, when I'm in the club. And no going out in the rain or freezing my butt off just to take a puff."

"There are now about a dozen studies from the U.S. and the U.K. all suggesting that youth who use e-cigarettes are more likely to go on to smoke conventional cigarettes," Marynak said. "But we are also concerned about use of e-cigarettes by kids for other reasons. Nicotine is highly addictive, and a recent Surgeon General's report found that nicotine exposure among adolescents can harm brain development."

Asked for his perspective, Alexander Prokhorov, MD, PhD, who directs the Tobacco Outreach Education Program at the University of Texas M.D. Anderson Cancer Center in Houston and who was not connected to either study, said the claims by e-cigarette manufacturers that they do not market their products to teens and young adults ring hollow.

"All you have to do is look at the ads showing up on the internet and at where e-cigarettes show up in television and movies. The reality is that they need young people to use these products to sustain their operations. This is all about nicotine dependence."

Prokhorov said it is no coincidence that the e-cigarette brand JUUL -- which is the top-selling e-cigarette, especially among teens -- has higher nicotine concentrations than most other vaping products on the market. It is also designed to resemble a USB flash drive, which may also appeal to younger users.

In 2016, the FDA began enforcing restrictions on sales of e-cigarettes to minors, but Marynak said there are additional "common sense" strategies that could further restrict access, including restricting e-cigarette sales to adult-only stores, restricting sales around schools, and restricting point-of-sale self-service displays.

The researchers reported no relevant conflicts of interest related to the study.

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